March 21, 2010

Health care under attack; Iggy awol

Ever since he became leader of the Liberal party, Michael Ignatieff has been searching for an issue on which he can make a real difference in the lives of Canadians.

He's tested topics ranging from the economy and Afghan detainees to government waste and foreign trade. But he's had virtually no impact on any of them.

Strangely, though, Ignatieff has ignored medicare, which needs a national champion to lead the fight against the wave of health privatization sweeping across Canada.

Health care ranks first or second in almost every poll asking Canadians to list their biggest concerns. More than 80 per cent of us also fear health-care spending will be slashed in coming years as Ottawa and provincial governments tackle their deficits.

And yet Ignatieff, like most federal politicians, appears afraid to enter what may be the most important debate in Canada over the next several years. Any talk of preserving or reforming medicare instantly becomes a point of controversy, and politicians like Ignatieff love to avoid controversy.

In an open letter last month to Stephen Harper outlining Liberal priorities for the current session of Parliament, Ignatieff urged him to implement 13 initiatives.

Not one of them dealt with health care.

Ignatieff's failure to even mention health care was a huge mistake because Canada's cherished medicare system is under siege.

Like every developed country, our system is faced with spiralling costs and uneven quality of care. Over the past decade, Ontario and other provinces have closed small hospitals, consolidated others and laid off nurses and other health-care workers in a bid to control health costs, which can eat up as much as 50 per cent of a provincial budget.

The main federal tool to regulate health care, the Canada Health Act, is no longer enforced by Ottawa. Indeed, some provinces, notably British Columbia and Quebec, blatantly thumb their noses at the act by allowing private hospitals and clinics to open without any fear of sanctions by Ottawa.

At the same time, supporters of private delivery of health care are increasingly vocal. They are touting the so-called benefits of private health care, about "choice" and "liberalization," which are softer words than "privatization."

Let's be clear, though. Private health care is first and foremost about making huge profits for private hospitals, insurance companies, doctors and others with a vested interest in private delivery of health services.

In Canada, the debate over health care is about to heat up again as Ottawa and the provinces get ready for the next major fight over funding.

That's because the current federal health accord, signed in 2004 by former prime minister Paul Martin, expires in 2014. That's four years from now, but many for-profit groups are already preparing their assault on medicare as we know it.

The 2004 accord gave the provinces $41 billion extra to help lower hospital wait times and improve overall health delivery. Last year, the federal government paid $129 billion in health transfers. The provinces would be hard-pressed to make up any cuts by Ottawa.

The coming talks are critical because, besides dealing with just money, they will offer an opportunity for Canada to reaffirm the basic tenets of medicare, especially equity, quality and sustainability.

Who will lead this fight?

Surely it won't be Harper, (LOL! - Ry eds) who isn't likely to give the provinces any extra money, but will allow them even greater power to introduce more and more private health care.

So it must fall to Ignatieff. Despite his reluctance so far, he still can become the champion of medicare. His first chance comes next weekend when, during their three-day policy conference in Montreal, the Liberals will hold a 75-minute session discussing the future of health care.

Ignatieff should use the occasion to defend medicare, counter the attacks by the private health-care advocates and outline a vision of how to fund the system in the future.